Utilization Review (UR) nurses review medical records to determine if patients are receiving cost-effective and appropriate care. UR nurses do not provide direct patient care, and job descriptions note that nurses need a deep knowledge of health insurance as well as excellent communication skills. Utilization Review nurses work in hospitals, agencies, or remotely. Do you have utilization review experience? There are many Utilization Review opportunities available for Registered Nurses or Licensed Practical Nurses. Find your perfect travel nurse job today.
The job responsibilities of a Utilization Review nurse include determining the medical necessity of various treatments and equipment. The UR nurse also uses guidelines and specialized algorithms to determine appropriate levels of care and communicates recommendations to physicians. Usually, the nurse should have prior clinical experience, but the type of setting may vary. Some settings that make the UR nurse marketable are acute care, home health care, or long-term care. Annual salaries in the United States for this specialty range from $77,000 - $94,000.